As Congress decides the fate of the Patient Protection and Affordable Care Act (PPACA), certain issues, such as efforts to reverse Medicaid expansion under the PPACA, are sure to receive more attention in the Senate than they did in the House, according to an article in The New York Times. The prospect of higher insurance premiums for older Americans living in rural areas will also loom larger in the upper chamber, where many Republicans hail from sparsely populated states.
“This process will not be quick or simple or easy,” Senate majority leader Mitch McConnell (R-Kentucky) told reporters.
Senator Mike Rounds (R-South Dakota) estimated that the Senate would spend at least two months working on the legislation.
The Times article points out that McConnell is likely to find the same tricky dynamic that Speaker Paul Ryan (R-Michigan) confronted in the House: Any bill that satisfies moderates risks alienating conservatives, and vice versa.
In addition, Medicaid expansion under the PPACA is expected to vex Republican leaders in the Senate in ways it did not in the House. Both Republican and Democratic senators from states that expanded the health care program have expressed deep misgivings about the House bill, which essentially repeals the expansion.
Republicans, holding 52 seats in the Senate, can’t afford to lose more than two members of their party on a vote to dismantle the PPACA, the Times article notes. They will not receive any support from Democratic senators or the Senate’s two independents, but they can count on Vice President Mike Pence to break a tie, if needed.
Rather than simply “improving” the new health care plan, as House GOP leaders had hoped, the Senate is starting over from scratch.
“Let’s face it,” said Senator Orrin Hatch (R-Utah), chairman of the Finance Committee: “The House bill isn’t going to pass over here.’’
Hospital executives, among the most outspoken critics of the bill, are in Washington, D.C., for the annual meeting of the American Hospital Association and will lobby the Senate this week. Thomas P. Nickels, an executive vice president of the association, predicted that the Senate would produce an “utterly different version” of the legislation, according to the article.
Source: The New York Times; May 8, 2017.